Rhabdomyolysis after major urologic surgery: Epidemiology, risk factors, and outcomes

Joseph J. Pariser, Shane M. Pearce, Sanjay G. Patel, Blake B. Anderson, Vignesh T. Packiam, Arieh L. Shalhav, Gregory T. Bales, Norm D. Smith

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective To study the epidemiology, risk factors, and outcomes of rhabdomyolysis (RM) after major urologic surgery. Materials and Methods The National Inpatient Sample (2003-2011) was used to identify patients who underwent radical prostatectomy, radical or partial nephrectomy, or radical cystectomy. Demographics included age, sex, race, and comorbidities. Factors examined included bleeding, hospital teaching status, minimally invasive technique, and development of RM. Multivariate logistic regression was used to identify independent risk factors of RM. Outcomes of mortality, acute kidney injury (AKI), length of stay, and charges in patients with RM were compared with those of controls. Results A weighted population of 1,016,074 patients was identified with 870 (0.1%) developing RM, which was significantly more likely for radical or partial nephrectomy and radical cystectomy patients compared with radical prostatectomy patients. On multivariate analysis, independent risk factors for RM included younger age, male sex, diabetes, chronic kidney disease, obesity, and bleeding. Race, minimally invasive technique, and teaching status were not associated with RM when controlling for other factors. Patients with RM experienced increases in mortality, AKI, length of stay, and hospital charges. Conclusion Rhabdomyolysis is a rare complication after urologic surgery. Risk factors include male sex, younger age, diabetes, chronic kidney disease, obesity, and perioperative bleeding. Patients who develop RM have a higher risk of AKI, mortality, prolonged hospital stay, and increased charges.

Original languageEnglish (US)
Pages (from-to)1328-1332
Number of pages5
JournalUrology
Volume85
Issue number6
DOIs
StatePublished - Jun 1 2015

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Rhabdomyolysis
Epidemiology
Acute Kidney Injury
Length of Stay
Cystectomy
Hemorrhage
Prostatectomy
Nephrectomy
Chronic Renal Insufficiency
Mortality
Obesity
Hospital Charges
Teaching Hospitals
Comorbidity
Inpatients
Teaching
Multivariate Analysis
Logistic Models
Demography

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Pariser, J. J., Pearce, S. M., Patel, S. G., Anderson, B. B., Packiam, V. T., Shalhav, A. L., ... Smith, N. D. (2015). Rhabdomyolysis after major urologic surgery: Epidemiology, risk factors, and outcomes. Urology, 85(6), 1328-1332. https://doi.org/10.1016/j.urology.2015.03.018

Rhabdomyolysis after major urologic surgery : Epidemiology, risk factors, and outcomes. / Pariser, Joseph J.; Pearce, Shane M.; Patel, Sanjay G.; Anderson, Blake B.; Packiam, Vignesh T.; Shalhav, Arieh L.; Bales, Gregory T.; Smith, Norm D.

In: Urology, Vol. 85, No. 6, 01.06.2015, p. 1328-1332.

Research output: Contribution to journalArticle

Pariser, JJ, Pearce, SM, Patel, SG, Anderson, BB, Packiam, VT, Shalhav, AL, Bales, GT & Smith, ND 2015, 'Rhabdomyolysis after major urologic surgery: Epidemiology, risk factors, and outcomes', Urology, vol. 85, no. 6, pp. 1328-1332. https://doi.org/10.1016/j.urology.2015.03.018
Pariser JJ, Pearce SM, Patel SG, Anderson BB, Packiam VT, Shalhav AL et al. Rhabdomyolysis after major urologic surgery: Epidemiology, risk factors, and outcomes. Urology. 2015 Jun 1;85(6):1328-1332. https://doi.org/10.1016/j.urology.2015.03.018
Pariser, Joseph J. ; Pearce, Shane M. ; Patel, Sanjay G. ; Anderson, Blake B. ; Packiam, Vignesh T. ; Shalhav, Arieh L. ; Bales, Gregory T. ; Smith, Norm D. / Rhabdomyolysis after major urologic surgery : Epidemiology, risk factors, and outcomes. In: Urology. 2015 ; Vol. 85, No. 6. pp. 1328-1332.
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AB - Objective To study the epidemiology, risk factors, and outcomes of rhabdomyolysis (RM) after major urologic surgery. Materials and Methods The National Inpatient Sample (2003-2011) was used to identify patients who underwent radical prostatectomy, radical or partial nephrectomy, or radical cystectomy. Demographics included age, sex, race, and comorbidities. Factors examined included bleeding, hospital teaching status, minimally invasive technique, and development of RM. Multivariate logistic regression was used to identify independent risk factors of RM. Outcomes of mortality, acute kidney injury (AKI), length of stay, and charges in patients with RM were compared with those of controls. Results A weighted population of 1,016,074 patients was identified with 870 (0.1%) developing RM, which was significantly more likely for radical or partial nephrectomy and radical cystectomy patients compared with radical prostatectomy patients. On multivariate analysis, independent risk factors for RM included younger age, male sex, diabetes, chronic kidney disease, obesity, and bleeding. Race, minimally invasive technique, and teaching status were not associated with RM when controlling for other factors. Patients with RM experienced increases in mortality, AKI, length of stay, and hospital charges. Conclusion Rhabdomyolysis is a rare complication after urologic surgery. Risk factors include male sex, younger age, diabetes, chronic kidney disease, obesity, and perioperative bleeding. Patients who develop RM have a higher risk of AKI, mortality, prolonged hospital stay, and increased charges.

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